Provider Demographics
NPI:1548064322
Name:QUINTERO, INDRA SOFIA (LPC-A)
Entity type:Individual
Prefix:
First Name:INDRA
Middle Name:SOFIA
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1316 N YARBROUGH DR STE 2A
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-7803
Mailing Address - Country:US
Mailing Address - Phone:915-373-6021
Mailing Address - Fax:
Practice Address - Street 1:1316 N YARBROUGH DR STE 2A
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-7803
Practice Address - Country:US
Practice Address - Phone:915-373-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX95698101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health